I have a spoiled rotten,10 yr old neutered male Shih Tzu, named Kuro. He's also blind, but still my sweet baby!
Although it's only him and me now, there's a lot of talking around our house. I didn't realize he knows so many words! Some people say it's repetition, but I prefer to think he's that smart.......
We moved to Michigan from Indiana 4 years ago, and for the first 7 years of Kuro's life, the only expense I had was vaccinations, grooming,and buying toys. ( Lots of toys)
But time passes on and age starts taking a toll, and he started having problems: bladder, tumor on paw,liver enzymes too high, dental work, eye problems,and for the past few months, skin problems.
Dr. Dhaliwal has done all of Kuro's surgeries, and worked with me on the other problems. He never loses his patience, and stays calm while I am asking my 100 questions .
Dr. Dhaliwal is definitely in the correct profession. It seems he has a passion for not only helping animals, but he takes every opportunity to learn new techniques so he can help them even more.
The staff is also very nice. They greet you with a smile, take the time to talk, explain meds,etc. and if Dr. D. doesn't call to check on Kuro after a procedure, the staff will, and that means a lot to me.
Michigan Avenue Animal Hospital is a caring place, and everyone makes sure your pet is given the best care. Whatever it takes to make you and your pet "HAPPY!"
Mammary Tumors in dogs and cats
(or breast) tumors are common in female dogs, but rare in male dogs and cats.
resection is recommended for the majority of mammary tumors.
may be required following surgery in some cases.
prognosis is good following surgical resection for most mammary tumors in
female dogs, but the prognosis is worse for certain tumors in dogs and all
mammary tumors in cats.
- Mammary tumors are more common in female dogs that are either not spayed or
were spayed after 2 years of age.
risk of a dog developing a mammary tumor is 0.5% if spayed before their first
heat (approximately 6 months of age), 8% after their first heat, and 26% after
their second heat. Spaying does not provide a protective effect against mammary
tumor development after 2 years of age.
spayed before 6 months of age have a 7-times reduced risk of developing mammary
cancer and spaying at any age reduces the risk of mammary tumors by 40% to 60%
treated with certain hormonal drugs, such as estrogens and progestins, may be
at an increased risk of developing mammary tumors.
has also been implicated with mammary tumors more common in obese dogs and dogs
fed home-made meals consisting of higher proportions of beef and pork and lower
proportions of chicken.
Incidence and Prevalence:
than a quarter of unspayed female dogs will develop a mammary tumor during
their lifetime. The risk is much lower for spayed female dogs, male dogs, and
cats of either gender.
female dogs, 50% of mammary tumors are benign and 50% are malignant. However,
few of the malignant mammary tumors are fatal.
contrast, over 85% of mammary tumors in cats are malignant and most of these
have an aggressive biologic behavior (i.e., mammary tumors in cats tend to be
locally invasive and metastasize to distant sites such as the lymph nodes and
Signs and Symptoms:
- A palpable mass underneath the skin of the abdomen is the most common findings
in dogs and cats with mammary tumors.
may be a single mass or multiple masses. In fact, over 50% of dogs with mammary
tumors will have more than one tumor.
have 5 pairs of mammary glands which are numbered 1 through 5 from front to
back. Although any gland can be affected, the majority (greater than 65%) of
mammary tumors develop in the fourth and fifth mammary glands.
tumors are often small, well-circumscribed, and firm. Malignant tumors can be
similar to benign tumors, but may also exhibit more aggressive behavior, such
as rapid growth, poorly defined borders, fixation to skin or underlying tissue,
and inflammation or ulceration.
mammary carcinoma is an aggressive type of mammary tumor seen in dogs and
humans. Dogs with inflammatory mammary carcinoma are often painful with swollen
mammary glands. The swelling is often diffuse and can involve either a single
mammary chain (i.e., all glands on either the left or right side) or all
mammary glands. Other signs include inappetence, weight loss, generalized
weakness, and swelling of one or both hind legs.
is recommended for all mammary tumors except inflammatory mammary carcinoma.
Inflammatory mammary carcinoma is generally NOT surgically removable.
options are few and these are best handled by a veterinary oncologist.
from a veterinary surgeon is recommended for all animals with mammary tumors,
particularly cats where more extensive surgery is recommended because of the
high risk of metastasis.
type of surgery depends on the size, location, and number of mammary tumors.
general, surgery is conservative for dogs with mammary tumors and involves
removal of either the mass alone or the affected mammary gland.
in cats, more aggressive surgery is recommended with removal of one or
preferably both mammary chains.
Physical examination, blood tests (complete blood count and serum
biochemistry), abdominal ultrasound, and chest radiographs are recommended for
cats and dogs with mammary tumors.
examination is necessary to assess general health status; the number, size, and
location of mammary tumors; and regional lymph nodes for evidence of metastasis
(or spread) of the mammary tumor.
tests are recommended to assess general health status as many animals with
breast cancer are older and may have other problems which should be considered
when developing a treatment plan. Occasionally, a coagulation profile will also
be recommended as a tendency for bleeding (disseminated intravascular
coagulation) has been reported in some dogs with malignant mammary tumors.
ultrasound and chest radiographs are used to assess the presence or absence of
metastasis to sites such as the regional and intra-abdominal lymph nodes,
liver, and lungs.
fine-needle aspirate does not differentiate benign from malignant tumors and
hence is not often performed.
a biopsy is not frequently recommended as the results will not change the type
or extent of treatment (i.e., surgery). However, a fine-needle aspirate should
be performed to distinguish mammary tumors from other skin masses, such as mast
fine-needle aspiration of the regional lymph nodes is recommended to assess for
evidence of metastatic disease, especially in cats where up to 50% will have
lymph node metastasis but only 20% of these lymph nodes have abnormalities
which are externally obvious or palpable.
is recommended for the diagnosis of inflammatory mammary carcinoma.
- The most important differential diagnosis for dogs with mammary tumors is other
skin masses, such as mast cell tumors, soft tissue sarcomas, and epithelial
possibilities, especially for inflammatory mammary carcinoma, include mastitis
and dermatologic disease (i.e., atopy or other allergies).
hyperplasia, in addition to the above differential diagnoses, should be
considered in cats with mammary masses or enlargement.
Disease-related complications can be divided into local and metastatic
problems are most often associated with rapidly-growing malignant tumors and
include inflammation, ulceration, and infection. If left untreated, this can
progress to systemic illness with poor appetite, weakness, and lethargy.
mammary tumors have the potential to metastasize to draining lymph nodes,
liver, lungs, and other sites. Clinical signs associated with metastatic
disease may not be apparent and depend on the site of metastasis.
- Surgical resection of the local
mammary tumor is recommended in both dogs and cats, especially if the tumor is
- Surgery may still be indicated if the tumor is
metastatic, particularly if the mammary tumor is ulcerated and infected.
usually involves removal of the mass(es) or affected mammary gland(s) in dogs.
cats, however, removal of all mammary tissue is recommended (i.e., bilateral
mastectomy). The draining lymph node should also be resected in cats, if
possible, to assess for evidence of metastasis. The mammary tumor and draining
lymph node should be submitted to a veterinary pathology laboratory for
diagnosis, grading, and assessment of surgical margins. This will provide
information on whether or not further treatment is required.
role of spaying female dogs with mammary tumors is controversial. The majority
of studies have shown no beneficial effect of spaying in preventing the
development of new mammary tumors or influencing the aggressiveness or
metastatic potential of existing mammary tumors. However, spaying at the time
of mammary tumor resection should be considered as it may have a beneficial
effect in dogs with mammary tumors (based on recent studies) and may prevent
unrelated diseases, such as pyometra.
role of chemotherapy in cats and dogs with malignant mammary tumors has not
been defined. For most mammary tumors in cats and dogs, hormonal therapy,
immunotherapy, and radiation therapy have either not been investigated or are
is not recommended for dogs with inflammatory mammary carcinoma because it does
not improve survival rate. Unfortunately, an effective treatment has not been
discovered. Radiation therapy in combination with a non-steroidal
anti-inflammatory drug called piroxicam has been shown to provide the most effective
palliation in dogs with inflammatory mammary carcinoma, but the prognosis
Complications of Surgery:
- Infection and wound breakdown are the most common surgical complications.
occurs in less than 5% of cats and dogs following surgery. Wound breakdown is
unusual but more common following resection of tumors from the fourth and fifth
mammary glands in dogs (due to movement of the hind legs slowing wound healing)
and most surgeries in cats (because the removal of large amounts of tissue
[i.e., one or both mammary chains] results in high tension on the wound).
bandages and cage confinement for 10 to 14 days after surgery may minimize the
risk of wound breakdown in these cases.
recurrence of the mammary tumor is possible if the tumor has not been
surgical margins should be assessed by a pathologist for the completeness of
excision. Further surgery or radiation therapy may be indicated if the tumor
has been incompletely resected.
recurrence should be distinguished from the development of new tumors.
mammary tumors are relatively common in both dogs and cats and new mammary
tumors can develop after surgery (and are independent of surgery and the
completeness of surgical resection).
surgery does not prevent metastatic disease from developing and chemotherapy
should be considered following surgery in cats and some dogs with malignant
mammary tumors. The complications associated with chemotherapy are dependent on
the drug used and the species (i.e., cat or dog).
- Activity should be restricted to short, leashed walks until suture removal.
use of a body bandage or cage confinement should be considered for cats and
dogs with a high risk of wound breakdown.
surgical wound should be checked twice daily for signs of infection or imminent
breakdown. These signs include redness, swelling, watery to purulent discharge,
the mammary tumor is malignant, the surgical site and regional lymph nodes should
be checked for local tumor recurrence and metastasis, respectively, every 3
months for the first 12 months after surgery and then every 6 months
ultrasound and chest radiographs are also recommended every 6 months to assess
for evidence of metastatic disease.
of new mammary tumors is relatively common. Cats and dogs should be checked for
new mammary tumors during annual general physical examinations.
dogs, there are a number of factors that influence the prognosis following
surgery. These prognostic factors include tumor size, clinical stage,
histologic diagnosis and grade, and various other histologic criteria.
tumors are cured by complete surgical resection, although the development of
new mammary tumors (both benign and malignant) is possible.
malignant tumors, inflammatory mammary carcinoma, ductular carcinoma,
carcinosarcoma, and sarcomas have a poorer prognosis than other types of
malignant mammary tumors.
median survival time for dogs with non-metastatic mammary adenocarcinoma is
greater than 420 days, compared to 25 days for dogs with inflammatory mammary
carcinoma and approximately 180 days for mammary sarcomas.
less than 15% of dogs with mammary adenocarcinoma will die as a result of their
tumor, compared to 65% with ductular carcinoma and 100% with carcinosarcoma and
inflammatory mammary carcinoma.
dogs, the size of malignant mammary tumors is an important consideration when
determining prognosis, both for local tumor recurrence and survival time.
median survival time following surgery for mammary tumors less than 5 cm in
diameter is between 420 and 784 days, compared to 210 to 280 days for tumors
greater than 5 cm in diameter.
local recurrence is more common in mammary tumors greater than 3 cm in
diameter, with 70% recurring compared to 30% for dogs with mammary tumors less
than 3 cm in diameter.
grade, which is calculated by pathologists, is also important in determining
the risk of local tumor recurrence, with 24% of grade I, 68% of grade II, and
90% of grade III mammary carcinomas recurring at the surgery site after
prognosis for cats with mammary tumors is guarded as mammary tumors tend to be
more aggressive and metastatic in cats. Many of the prognostic factors used in
dogs also apply to cats, although the extent of surgery is also important in
tumor size, the median survival time for tumors less than 3 cm in diameter is
over 2 years, compared to 6 months for cats with mammary tumors greater than 3
cm in diameter.
degree of tumor differentiation, which is also calculated by the pathologists,
has an important influence on survival time with 100% of cats with well
differentiated mammary tumors alive at 12 months, compared to 42% of cats with
moderately differentiated tumors and no cats with poorly differentiated mammary
tumors alive at 12 months.
time for cats with mammary tumors is also dependent on the extent and
aggressiveness of surgical resection, with a median survival time of 917 days
after bilateral mastectomy (i.e., surgical resection of all mammary tissue),
566 days after unilateral mastectomy (i.e., surgical resection of either the
left or right mammary chains), and 216 days after lesser surgery, such as
removal of either the mass alone or affected mammary gland.
tumors can be prevented by spaying before 6 months of age. The risk of
developing a mammary tumor is 0.5% in dogs spayed before 6 months of age (or
their first heat) compared to 26% (and up to 71% in some reports) if spayed
after 2 years of age.
spayed before 6 months of age have a 7-times reduced risk of developing mammary
cancer and spaying at any age reduces the risk of mammary tumors by 40% to 60%
factors that may reduce the incidence of mammary tumors include feeding a
well-balanced diet and avoiding obesity and the administration of hormones
(particularly progesterone or mixed estrogen-progesterone drugs).
I would like to truly thank Dr. Dhaliwal and his entire staff for their professional veterinary expertise in caring for my dog Mandy. From the moment I walked into the office, I was comforted and reassured that my dog could recover from her affliction.
Mandy previously had surgery at another veterinary hospital for the removal of a growth on her hind leg. For some unfortunate reason, the area became badly infected that the doctor's opinion was amputation to save Mandy's life.
At first, I was devastated about this news and wanted to get a second opinion. Therefore, I began seeking other veterinary hospitals that specialized in this area. However, for some reason Michigan Avenue Animal Hospital would constantly reappear on my list. I began to read the testimonies from his previous clients and suddenly a peaceful feeling came over me. Even though Dr. Dhaliwal's hospital was a great distant from Detroit to Ypsilanti Michigan, it was worth the ride.
Mandy's outcome was the same, yet the calming and patient manner in which my dog and I were given from Dr. Dhaliwal and his loving staff made a difference. Today, Mandy is still running, climbing and playing even with three legs and I am thankful for the time and quality of life I still share with her.